Any practice described in this book should be applied by the reader in accordance with professional standards of care used in relation to the unique circumstances that may apply in each situation. I would like to dedicate this book to all my students who emphasize that learning is lifelong, we will never know everything, but we know where to look or who to ask. We suggest this book be used as a companion to our textbook, Primary Care: The Art and Science of Advanced Practice Nursing, which further elaborates on each rationale.
After you pass the certification exam, this book can be used as a study guide to continually refresh your knowledge base. We sincerely wish you success in certification and hope that this book contributes in some small way to that success.
UNIT ONE
INTRODUCTION
Achieving Success on a Certification Examination
APRN certification is not mandated, although most states currently require passing the appropriate certification exam as a prerequisite for licensure to perform advanced nursing functions. In 2006, the NCSBN released a draft vision paper titled "The Future Regulation of Advanced Practice Nursing." This started a formal dialogue between many stakeholders in nursing, which included regulation, education, certification and practice. This dialogue, the work of the APRN Consensus Work Group and the NCSBN APRN Advisory Committee, culminated in the publication in 2008 of "The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education," often referred to as "BLOND."
This change is in recognition of the need for more nurse practitioners with knowledge of the care of older adults as well as adults. The test development committee determines the pass result after careful consideration of the content of the test questions.
Test-Taking Skills
Once you have identified the topic of the question, you must also identify the problem that the question is about. Your first response is always the therapeutic response: the acknowledgment and validation of the client's feelings. Another crucial element is your ability to identify the person the question relates to.
In this question, the person who is the focus of the question is Mr. The keyword in the stem is best answer. You have identified the problem and the person who is the focus of the question.
UNIT TWO
EVALUATION AND PROMOTION OF
CLIENT WELLNESS
Health Promotion
Which of the following interventions would you suggest she do to prevent Mildred from falling. 3-96 When discussing sexuality with the mother of a 4-year-old, you should be concerned about which of the following. 3-97 Which of the following criteria is not diagnostic of a child with attention deficit hyperactivity disorder (ADHD).
4-4 Which of the following best describes the Lamaze method of childbirth education. I'm worried my daughter has it too.” The clinician knows that according to the National Cholesterol Education Program (NCEP) guidelines for children and adolescents, the acceptable range for total cholesterol (mg/dL) for children aged 2-18 years.
Care of the Emerging Family
- ADHD
4-2 Which of the following instructions should be included in the discharge teaching plan to help parturients recognize early signs of complications. The clinician should be aware of the following regarding the assessment of growth problems and idiopathic short stature. Which medicine should I give him?" Which of the following cough and cold products would you recommend?
4-80 Which of the following behavioral assessments is not included in the Denver Developmental Screening Test. 4-82 What is the presumptive symptom of pregnancy involving tingling or frank pain in the breasts. 4-93 Which of the following antibiotics is the best choice for acute pyelonephritis when it occurs in the seventh month of pregnancy.
If a wait-and-see approach is not indicated, which of the following antibiotics should be prescribed? Which of the following would be useful in the diagnosis of intrauterine fetal death. They should be in the back seat of the vehicle, preferably in the middle of the seat.
Phenobarbital should be used with extreme caution because of the slow rate of metabolism of the barbiturate from the infant to the breast. An incomplete abortion occurs when part of the products of conception (usually the placenta) remains in the uterus. Because of the life-threatening nature of a pulmonary embolism, it is the first entity to be ruled out.
Growth and Development
Sleep duration for young babies is variable, but by the end of the first year, most babies sleep through the night. 5-51 Which of the following is due to changes in cell-mediated immune function that occur with aging. 5-56 The photosensitivity of the epidermis increases in older adults due to the following normal developmental changes of aging skin.
5-104 By the end of the first year of life, normal infants show interest in an object pointed out by a caregiver. 5-113 Cross-cultural studies of Piaget's theory of cognitive development provide which of the following conclusions. By the beginning of the preschool period, children can remember and reverse a sequence of two numbers.
They must be able to use more words than gestures to express themselves, and the words must be understandable most of the time to the parents. Although there are changes in the elasticity of the eye, their effects at this time are usually minor. In stage III, there is further growth of the testicles and scrotum, and the penis enlarges and becomes longer.
Dysfunction in the actions of the neurotransmitters dopamine and norepinephrine may be key to the pathophysiological mechanisms of ADHD. All answers include the actual changes that occur in the respiratory systems of older adults. The decrease in visual acuity is related to changes in the shape and elasticity of the lens, which are not related to exercise.
Health Counseling
6-48 In counseling an obese client to lose weight, which of the following is the best recommendation you can make. You tell him to observe any lesions he has and to do which of the following. 6-83 Primary prevention measures for sexually transmitted diseases and unintended pregnancies should be based on an understanding of which of the following psychosocial.
What is the best recommendation you can give them to prevent an accidental drowning of the 2 year old. When assessing his risk profile, which of the following should be considered? Obesity is one of the main contributors to the development of osteoarthritis of the knee.
This should be done at every visit, regardless of the reason the client is being seen. The couple should be seen together so they can get advice on the chronicity of the syndrome and how it can be managed. You do not have enough history in the query stem to determine whether the client should bear weight.
Retiree health benefits are not relevant to this question about the origin of the client's cough. Simply informing your client about the dangers of smoking and its health consequences is not enough. To prevent lymphedema, inform the client of the following measures: Protect the affected arm from.
UNIT THREE
ASSESSMENT AND MANAGEMENT OF
Neurological Problems
- MMSE
7-26 Which of the four types of stroke is the most common and has a gradual onset? 7-32 When teaching a client with multiple sclerosis, the practitioner should emphasize all of the following except. 7-60 Which of the following may immediately follow a stroke in an older adult and is the body's attempt to maintain perfusion.
7-86 Which of the following symptoms related to memory suggests depression rather than delirium or dementia in the older adult. 7-105 Which of the following laboratory results would indicate a specific infection in the central nervous system. Ageusia is the loss of the sensation of taste or the ability to distinguish sweet, sour, salty and bitter tastes.
Clients with senile dementia of the Alzheimer type (SDAT) commonly die of pneumonia (the leading cause of death for clients with Alzheimer's disease). A client with meningitis would show signs of irritation of the brain and meninges, such as a stiff neck. There is no medicine or surgical approach that will prevent the development of the disease.
A subdural hematoma is the most common of the intracranial hematomas, occurring in 10% - 15% of all head injuries. A few red blood cells in the cerebrospinal fluid may result from the lumbar puncture procedure. A depressed person has feelings of hopelessness and helplessness and has no energy to "fight" the cause of the fear.
Integumentary Problems
- SPT I B. SPT II
- SPT III D. SPT IV
You know he doesn't understand your directions when he tells you which of the following. 8-16 Permethrin (Elimite) applied over the body overnight from the neck down is the preferred treatment for. 8-23 A mother complains that her side-lying newborn infant may appear red on the dependent side of the body while appearing pale on the upper side.
8-26 What is the name of the connection between the surface of the skin and the underlying structure. 8-43 What type of hemangioma in a newborn occurs on the back of the head and is usually not seen when it is covered by hair. 8-57 Which form of acne is more common in middle-aged and older adults and causes changes in skin color, enlarged pores, and thickening of the soft tissues of the nose.
Nystatin oral suspension for 2 weeks, 2 – 3 mL on each side of the mouth, kept as long as possible B. 8-84 What is the name of the acquired disorder characterized by complete loss of pigment of the involved skin. 8-86 Which of the following warts (human papillomavirus [HPV]) looks like a cauliflower and is usually found in the anogenital region.
